| NPI | 1649218785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0000X Podiatrist, Sports Medicine (Licence: IN 07000296A) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07000296A) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-11-27 |